Outline

Introduction

The aim of this study was to identify predictive factors for successful long-time outcome after operative treatment of lumbar spinal stenosis (LSS).

Material and Methods

Between 01.01.1992 and 31.12.1997 150 patients with symptomatic lumbar stenosis and failure of conservative treatment underwent operative treatment in our institution. LSS was diagnosed with conventional X-ray, CT, Myelography and MRI. Operative treatment included mono- or bilateral; uni- or multisegmental decompression with or without fusion. Follow-up included clinical investigation, functional and neurological outcome as well as self-evaluation tests.

Results

60 (40%) patients came to postoperative follow-up after 3-8 years. Average age was 65 (30-84) years. Women exceeded men (39/21). 69,5% of all patients were operated bilateral. 52,5% were operated in one segment (L4/5 in 42%). 35,6% were operated in two segments (Combination of L3/4 and L4/5 in 23%). Apart from isolated operative decompression (72%), 17 patients were fused either with bone graft (15%) or instrumentation (13%). 77% of all patients were without clinical symptoms during first postoperative time. At time of follow-up 15 of these patients reported about recurring symptoms (Low back pain in 53%). Factors that positively affected the operative outcome were: Patient age, predominant leg pain and missing of sensory or motoric deficits prior to the operation.

Discussion

There is still a debate going on what kind of patients with symptomatic LSS benefit most from surgical interventions over time. In our study we were able to identify factors that predict a successful outcome. This might help with preoperative patient selection in the future.